chronic mesenteric ischaemia

chronic mesenteric ischaemia

A condition characterised by intermittent severe ischaemia resulting in abdominal colic, beginning 15–30 minutes post-prandially and lasting 1-2 hours, which appears when 2 or all 3 of the superior and inferior mesenteric and coeliac major abdominal arteries have severe atherosclerosis. Because the intestine’s O2 demand increases with meals, patients may avoid the pain by not eating, thus losing weight. Malabsorption may occur because absorption is O2-dependent.

Popularly known as abdominal angina, chronic mesenteric ischaemia is preferred by journals that use British English, while chronic intestinal ischemia is used in journals that publish in American English.
 
Management
Bypass, endarterectomy, vascular reimplantation, percutaneous transluminal angioplasty.
References in periodicals archive ?
Acute and chronic mesenteric ischaemia remains a complex disease entity characterised by perfusion abnormality to the GI tract.
Chronic mesenteric ischaemia affects elderly individuals with history of atherosclerosis.
Acute mesenteric ischaemia of 15 patients were correlated with surgical findings, the sensitivity and specificity of each MDCT finding were assessed with surgical findings, while MDCTA findings of chronic mesenteric ischaemia of 22 patients were correlated with DSA findings and then subsequently their sensitivity and specificity were analysed.
MDCT findings in chronic mesenteric ischaemia are given in Table/Fig.
Common findings of chronic mesenteric ischaemia are stenosis of celiac trunk (Table/Fig.
Stenosis of superior mesenteric artery is usually associated with chronic mesenteric ischaemia and was seen in 17 out of 22 patients (77%).
Chronic mesenteric ischaemia is a slowly progressing disease process.
Stenosis of SMA is a common finding (77%) in majority of cases of chronic mesenteric ischaemia and is also associated with stenosis of celiac trunk and IMA.
reported a case series of 14 patients with chronic mesenteric ischaemia treated by percutaneous transluminal angioplasty (PTA) with or without a stent.
In longstanding atherosclerotic disease two or more mesenteric vessels leads to Chronic Mesenteric Ischaemia.
The dictum in cases of acute on chronic mesenteric ischaemia is resection of the affected part of bowel with the blind loops exteriorized as stomas to facilitate regular inspection of bowel ends for viability.
In this case of a 47-year-old male who was diagnosed as acute on chronic mesenteric ischaemia with massive bowel gangrene, who underwent massive resection and end-to-end anastomosis of small bowel survived in spite of more than 50% stenosis and thrombotic occlusion of Superior Mesenteric Artery and Inferior Mesenteric Artery.

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